Intra-urban variability of long-term exposure to PM2.5 and NO2 in five cities in Colombia.

Rapidly urbanizing cities in Latin America experience high levels of air pollution which are known risk factors for population health. However, the estimates of long-term exposure to air pollution are scarce in the region. We developed intraurban land use regression (LUR) models to map long-term exposure to fine particulate matter (PM2.5) and nitrogen dioxide (NO2) in the five largest cities in Colombia. We conducted air pollution measurement campaigns using gravimetric PM2.5 and passive NO2 sensors for 2 weeks during both the dry and rainy seasons in 2021 in the cities of Barranquilla, Bucaramanga, Bogotá, Cali, and Medellín, and combined these data with geospatial and meteorological variables. Annual models were developed using multivariable spatial regression models. The city annual PM2.5 mean concentrations measured ranged between 12.32 and 15.99 µg/m3 while NO2 concentrations ranged between 24.92 and 49.15 µg/m3. The PM2.5 annual models explained 82% of the variance (R2) in Medellín, 77% in Bucaramanga, 73% in Barranquilla, 70% in Cali, and 44% in Bogotá. The NO2 models explained 65% of the variance in Bucaramanga, 57% in Medellín, 44% in Cali, 40% in Bogotá, and 30% in Barranquilla. Most of the predictor variables included in the models were a combination of specific land use characteristics and roadway variables. Cross-validation suggests that PM2.5 outperformed NO2 models. The developed models can be used as exposure estimate in epidemiological studies, as input in hybrid models to improve personal exposure assessment, and for policy evaluation.

Intraurban Geographic and Socioeconomic Inequalities of Mortality in Four Cities in Colombia.

Mortality inequalities have been described across Latin American countries, but less is known about inequalities within cities, where most populations live. We aimed to identify geographic and socioeconomic inequalities in mortality within the urban areas of four main cities in Colombia. We analyzed mortality due to non-violent causes of diseases in adults between 2015 and 2019 using census sectors as unit of analysis in Barranquilla, Bogotá, Cali, and Medellín. We calculated smoothed Bayesian mortality rates as main health outcomes and used concentration indexes (CInd) for assessing inequalities using the multidimensional poverty index (MPI) as the socioeconomic measure. Moran eigenvector spatial filters were calculated to capture the spatial patterns of mortality and then used in multivariable models of the association between mortality rates and quintiles of MPI. Social inequalities were evident but not consistent across cities. The most disadvantaged groups showed the highest mortality rates in Cali. Geographic inequalities in mortality rates, regardless of the adults and poverty distribution, were identified in each city, suggesting that other social, environmental, or individual conditions are impacting the spatial distribution of mortality rates within the four cities.

Air pollution, sociodemographic and health conditions effects on COVID-19 mortality in Colombia: An ecological study.

OBJECTIVE: The present study aimed to determine the association between chronic exposure to fine particulate matter (PM2.5), sociodemographic aspects, and health conditions with COVID-19 mortality in Colombia. METHODS: We performed an ecological study using data at the municipality level. We used COVID-19 data obtained from government public reports up to and including July 17th, 2020. We defined PM2.5 long-term exposure as the 2014-2018 average of the estimated concentrations at municipalities obtained from the Copernicus Atmospheric Monitoring Service Reanalysis (CAMSRA) model. We fitted a logit-negative binomial hurdle model for the mortality rate adjusting for sociodemographic and health conditions. RESULTS: Estimated mortality rate ratios (MRR) for long-term average PM2.5 were not statistically significant in either of the two components of the hurdle model (i.e., the likelihood of reporting at least one death or the count of fatal cases). We found that having 10% or more of the population over 65 years of age (MRR = 3.91 95%CI 2.24-6.81), the poverty index (MRR = 1.03 95%CI 1.01-1.05), and the prevalence of hypertension over 6% (MRR = 1.32 95%CI1.03-1.68) are the main factors associated with death rate at the municipality level. Having higher hospital beds capacity is inversely correlated to mortality. CONCLUSIONS: There was no evidence of an association between long-term exposure to PM2.5 and COVID-19 mortality rate at the municipality level in Colombia. Demographics, health system capacity, and social conditions did have evidence of an ecological effect on COVID-19 mortality. The use of model-based estimations of long-term PM2.5 exposure includes an undetermined level of uncertainty in the results, and therefore they should be interpreted as preliminary evidence.

¿Son las mascotas, perro o gato, un factor de riesgo o protector para el desarrollo o exacerbación del asma? Revisión sistemática de revisiones sistemáticas / Are pets, dog or cat, a risk or a protector factor for the development or exacerbation of asthma? Systematic review of systematic reviews

RESUMEN Antecedentes Estudios previos han mostrado resultados contradictorios de la asociación entre la exposición a mascotas (gato o perro) y asma. La evidencia científica previa no ha sido clara en definir si evitar o permitir la exposición puede prevenir, mejorar o empeorar el desarrollo del asma o de sus síntomas. Objetivo Intentar dilucidar la relación controversial que existe entre la exposición a las mascotas, perro o gato, y su efecto en el desarrollo del asma, o la exacerbación de sus síntomas, tanto en niños como en adultos. Metodo Se realizó una búsqueda estandarizada en cinco bases de datos electrónicas por parte de un evaluador independiente. La muestra final de estudios incluidos en la revisión sistemática de revisiones sistemáticas fue tamizada y sintetizada mediante una tabla maestra. Se realizó una descripción narrativa de los resultados. Resultados En esta revisión sistemática de revisiones sistemáticas se encontró principalmente que tener gato podría ser un factor de riesgo y tener perro un factor protector para el desarrollo del asma. No obstante, la exposición temprana a cualquiera de las dos mascotas (antes de cumplir 2 años) disminuye la probabilidad de desarrollar síntomas de asma y sibilancias en la edad escolar. Además, tener un antecedente de sensibilización a los alergenos de dichas mascotas puede convertirse en un factor de riesgo para la exacerbación del asma, tanto en niños como en adultos.(AU)

ABSTRACT Background Preliminary studies have shown conflicting results on the association between exposure to pets (cat or dog) and asthma. Previous scientific evidence has not been clear to determine if avoiding or allowing the exposure to pets could prevent, improve, or worsen the development of asthma and its symptoms. Objective To try to explain the controversial relationship between exposure to pets (dog or cat) and its effect on the development of asthma or the exacerbation of symptoms in both children and adults. Methods A standardized search in five electronic databases by an independent reviewer was carried out. The final sample of studies included in the overview of systematic reviews was screened and synthesized through a master table. A narrative description of the results was made. Results This systematic review of systematic found determined principally that having a cat could be a risk factor and having a dog a protective factor in the development of asthma. However, early exposure to both cats and dogs (before the age of two) reduces the probability of asthma symptoms and wheezing in the school years. Additionally, having antecedents of sensibilization to pets allergen could be a risk factor to exacerbate asthma in both children and adults.(AU)

[Are pets, dog or cat, a risk or a protector factor for the development or exacerbation of asthma? Systematic review of systematic reviews]. / ¿Son las mascotas, perro o gato, un factor de riesgo o protector para el desarrollo o exacerbación del asma? Revisión sistemática de revisiones sistemáticas.

BACKGROUND: Preliminary studies have shown conflicting results on the association between exposure to pets (cat or dog) and asthma. Previous scientific evidence has not been clear to determine if avoiding or allowing the exposure to pets could prevent, improve, or worsen the development of asthma and its symptoms. OBJECTIVE: To try to explain the controversial relationship between exposure to pets (dog or cat) and its effect on the development of asthma or the exacerbation of symptoms in both children and adults. METHODS: A standardized search in five electronic databases by an independent reviewer was carried out. The final sample of studies included in the overview of systematic reviews was screened and synthesized through a master table. A narrative description of the results was made. RESULTS: This systematic review of systematic found determined principally that having a cat could be a risk factor and having a dog a protective factor in the development of asthma. However, early exposure to both cats and dogs (before the age of two) reduces the probability of asthma symptoms and wheezing in the school years. Additionally, having antecedents of sensibilization to pets allergen could be a risk factor to exacerbate asthma in both children and adults.

ANTECEDENTES: Estudios previos han mostrado resultados contradictorios de la asociación entre la exposición a mascotas (gato o perro) y asma. La evidencia científica previa no ha sido clara en definir si evitar o permitir la exposición puede prevenir, mejorar o empeorar el desarrollo del asma o de sus síntomas. OBJETIVO: Intentar dilucidar la relación controversial que existe entre la exposición a las mascotas, perro o gato, y su efecto en el desarrollo del asma, o la exacerbación de sus síntomas, tanto en niños como en adultos. METODO: Se realizó una búsqueda estandarizada en cinco bases de datos electrónicas por parte de un evaluador independiente. La muestra final de estudios incluidos en la revisión sistemática de revisiones sistemáticas fue tamizada y sintetizada mediante una tabla maestra. Se realizó una descripción narrativa de los resultados. RESULTADOS: En esta revisión sistemática de revisiones sistemáticas se encontró principalmente que tener gato podría ser un factor de riesgo y tener perro un factor protector para el desarrollo del asma. No obstante, la exposición temprana a cualquiera de las dos mascotas (antes de cumplir 2 años) disminuye la probabilidad de desarrollar síntomas de asma y sibilancias en la edad escolar. Además, tener un antecedente de sensibilización a los alergenos de dichas mascotas puede convertirse en un factor de riesgo para la exacerbación del asma, tanto en niños como en adultos.

[Effectiveness of the nursing interventions for the diagnosis "ineffective management of therapeutic regimen"]. / Eficacia de las intervenciones de enfermería para el diagnóstico "manejo inefectivo del régimen terapéutico".

OBJECTIVE: To evaluate the efficacy of domiciliary nursing interventions in the diagnosis of Ineffective Therapeutic Regimen Management in adults with chronic diseases. METHOD: A controlled clinical trial. We made the evaluation of the labels Treatment Behaviour: Illness or Injury and Knowledge: Treatment Regimen of the Nursing Outcomes Classifications. Participants were randomly assigned into two groups, the experimental group received the interventions recommended in the Nursing Interventions Classifications, and the control group received the usual care from the institution. The labels final results of two groups were compared with analysis of covariance. RESULTS: A difference of 1.1 points was found in the label Treatment Behaviour: Illness or Injury and of 1.5 points in the label Knowledge: Treatment Regimen when we compared the treatment and control group. CONCLUSION: The domiciliary nursing interventions are effective for the nursing diagnosis of Ineffective management of therapeutic regimen in adults with chronic diseases.